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Hearing Adjournment Request Form

Purpose

Complete this form to request an adjournment of the Appeals Committee hearing. An adjournment is a request to reschedule to the next available hearing date.

This form must be submitted in advance of the scheduled hearing date.

Notice of Collection

Personal information in this form is collected under the authority of the applicable City of Burlington's Licensing By-Laws and the Property Standards By-Law, and will be used to process applications for an appeal. Information, including completed forms, you provide to the Burlington Appeals Committee forms part an adjudicative record that is a public record available to parties, participants and the general public. Under Section 27 of the Municipal Freedom of Information and Protection of Privacy Act, the provisions protecting individual privacy in Part 2 of the Act do not apply to this information. Questions about this collection should be directed to the City Clerk, Phone: 905-335-7777, ext. 7480, clerks@burlington.ca

This request to adjourn is being made by

the Appellant

By-law Compliance

The adjournment is requested for:

Business Licence Decision Notice

Property Standards Order

Name of Appellant (License Applicant/Licensee/Property Owner)

Address:

Unit:

City:

Province:

Postal code:

Primary phone number:

Email address:

Business Licence Decision Notice Number/Property Standards Order Number

Request to adjourn the hearing scheduled for: (date mm/dd/yyyy)

I understand that Burlington Appeals Committee hearings are scheduled for the last Thursday of every month and that if this Adjournment Request is granted, the hearing will be rescheduled on the next available hearing date.

Briefly explain your reason for requesting that the hearing be adjourned:

I have contacted the other party and they:

consent to the adjournment

do not consent to the adjournment

Appellant/Authorized Agent or By-law Compliance Signature:

Clear